Twitterville Notebook: The first live-tweeted surgery

My friend Tom Stitt, who has become my go-to guy for information on social media and the medical industry sent me a note that alerted me to the fact that Henry Ford Hospital in Detroit was about to perform the first live-tweeted surgery. And it wasn't some minor procedure, but a robotic procedure to remove a cancer.

He put me in touch with Bill Ferris, manger in the Henry Ford Medical web services department, who explained that the procedure would be performed in Detroit and the Tweeting would be directed at 450 medical professionals attending a robotic surgery conference at the Hotel Bellagio in Las Vegas.

As a Twitter enthusiast, this was extremely exciting. Once again, history was being made as I was writing the book. In fact, for the surgical team involved, Twitter was just a simply attempt to remotely communicate more effectively than previously. It turned out to be just one small step for medical education. Next time, online video will be added.

Still, it shows how Twitter is becoming part of every day solutions to a great number of different professions. It also demonstrates that those who argue social media has no place in the medical profession really should stop talking and start paying attention.

The following are my interview notes with Bill, who was in the operating room during the surgery and tweeted answers to some of the nontechnical questions. Dr. Laungani and Dr. Peabody did most of the live tweeting of the procedure @HenryFordNews . You can see the surgical tweetstream by going to Twitter Search and typing in #TWOR , the hashtag that they used.

1. What social media tools does Henry Ford Medical Center use? How did it get to Twitter to begin with?

Henry Ford Health System uses Twitter, YouTube and podcasting. We currently have one provider blog , which is authored by a certified nurse midwife. It is in conjunction with a patient support group that she leads on the same topic on the topic of menopause. We are working on an additional blog.

I registered our Twitter account in 2007, but it wasn't until fall of 2008 when we started to use it. After I personally had some favorable experiences with companies on Twitter, it was something that I thought we should do at Henry Ford as well. Up until the surgery the bulk of our tweets were news releases posted through Twitterfeed. The remainder were links to upcoming classes and events or to stories done by others that reference Henry Ford.

2. What was the thinking that got Henry Ford Medical to live tweet a surgery?

I don't recall exactly, but I think it came from a couple brainstorming sessions. One was on new ways to use social media beyond distributing releases and announcements and the other was how to promote the International Robotics Urology Symposium [IRUS]. Somehow it came together.

3. What are the medical training implications of live tweeting surgery and/or other medical procedures?

I'm largely unqualified to answer this question without a background in medical training. But the fact that it does allow for interactivity, as well as an archive for future review would both seem to be important components. Twitter isn't the only way to achieve this, but it is a way. I think it's safe to say that we learned from this experience that you need to have a visual component as well and it would have been enhanced had all followers had access to the video stream.

In terms of education though, it doesn't have to be limited to medical training. There is also a patient education component to this. While a lay person wouldn't necessarily understand all medical jargon, it would provide a roadmap of the surgery which I would view as helpful if I or a loved one were having the procedure. It would also give a non-medical person 140-character access to an expert and a view into the operating room.

4. How was the patient selected? What concerns did he have?

The case/procedure/patient were selected first because of the educational value it would provide to conference participants. The Twittering of the surgery came later.

5. What legal concerns were there? What regulatory issues did you have to consider?

We had received clearance to broadcast the surgery already, so there weren't additional concerns. The procedure itself was already being made public, plus there was no patient identification. Honestly, I was in the in same room during the procedure and I couldn't tell you anything about the patient except that he was male.

6. There is a "conventional wisdom" that medical and related organizations should avoid social media. How would you respond them?

I would disagree. Medical and related organizations have some of the same goals as all organizations. Things like recruitment and brand building to name two, aren't industry specific at all.

Where it gets fuzzy is how far do you extend a conversation with a patient, or a potential patient? Because a person's health is so intimate, you don't want to go barging in. At the same time, and I'm speaking as a person here and not a hospital employee, in trying and frightening times I'd want to feel like I had any sort of additional connection to my doctor or hospital that I could. A tool like Twitter can provide another touch point. The trick is to find the right balance and give patients a way to connect with the organization without being intrusive. I'm not sure where that balance point is or the best way to achieve it.

And then there are the other issues related to privacy, legal, billing and others. But I think that these areas can be handled with policies and procedures.

7. What device was used to tweet in surgery? How was it kept sterile?

We used a laptop with Tweetdeck installed on it. It was outside the sterile field. With it being a robotic surgery, Dr. Khurshid A. Guru, the primary surgeon, was at the controls of the robot instead of standing over the patient. Also, the area for the surgery is being displayed in 3-D on large monitors so those assisting (robotic surgery involves a large team) can see what is happening. This made it possible for the surgeons twittering to have a good view and be able to accurately describe what was happening, and do it from a safe distance.

That's a pretty broad question. As it relates to medical training, I think we need to study a little more to see how formal it can become. Can you offer study credits for following a procedure on Twitter, and what would that entail? Where are the limits to what can effectively be taught with this sort of method? And can Twitter or other social media offer things that current methods can't?

I do think there is considerable opportunity when it comes to research. Not only for collaboration amongst researchers, but even in finding patients for clinical trials.

Finally, from a traditional marketing and PR perspective, budgets for provider marketing are generally pretty limited. Social media does provide a relatively low cost option for spreading your message and reaching out to patients and doctors.

My friend Tom Stitt, who has become my go-to guy for information on social media and the medical industry sent me a note that alerted me to the fact that Henry Ford Hospital in Detroit was about to perform the first live-tweeted surgery. And it wasn't some minor procedure, but a robotic procedure to remove a cancer.

He put me in touch with Bill Ferris, manger in the Henry Ford Medical web services department, who explained that the procedure would be performed in Detroit and the Tweeting would be directed at 450 medical professionals attending a robotic surgery conference at the Hotel Bellagio in Las Vegas.

As a Twitter enthusiast, this was extremely exciting. Once again, history was being made as I was writing the book. In fact, for the surgical team involved, Twitter was just a simply attempt to remotely communicate more effectively than previously. It turned out to be just one small step for medical education. Next time, online video will be added.

Still, it shows how Twitter is becoming part of every day solutions to a great number of different professions. It also demonstrates that those who argue social media has no place in the medical profession really should stop talking and start paying attention.

The following are my interview notes with Bill, who was in the operating room during the surgery and tweeted answers to some of the nontechnical questions. Dr. Laungani and Dr. Peabody did most of the live tweeting of the procedure @HenryFordNews . You can see the surgical tweetstream by going to Twitter Search and typing in #TWOR , the hashtag that they used.

1. What social media tools does Henry Ford Medical Center use? How did it get to Twitter to begin with?

Henry Ford Health System uses Twitter, YouTube and podcasting. We currently have one provider blog , which is authored by a certified nurse midwife. It is in conjunction with a patient support group that she leads on the same topic on the topic of menopause. We are working on an additional blog.

I registered our Twitter account in 2007, but it wasn't until fall of 2008 when we started to use it. After I personally had some favorable experiences with companies on Twitter, it was something that I thought we should do at Henry Ford as well. Up until the surgery the bulk of our tweets were news releases posted through Twitterfeed. The remainder were links to upcoming classes and events or to stories done by others that reference Henry Ford.

2. What was the thinking that got Henry Ford Medical to live tweet a surgery?

I don't recall exactly, but I think it came from a couple brainstorming sessions. One was on new ways to use social media beyond distributing releases and announcements and the other was how to promote the International Robotics Urology Symposium [IRUS]. Somehow it came together.

3. What are the medical training implications of live tweeting surgery and/or other medical procedures?

I'm largely unqualified to answer this question without a background in medical training. But the fact that it does allow for interactivity, as well as an archive for future review would both seem to be important components. Twitter isn't the only way to achieve this, but it is a way. I think it's safe to say that we learned from this experience that you need to have a visual component as well and it would have been enhanced had all followers had access to the video stream.

In terms of education though, it doesn't have to be limited to medical training. There is also a patient education component to this. While a lay person wouldn't necessarily understand all medical jargon, it would provide a roadmap of the surgery which I would view as helpful if I or a loved one were having the procedure. It would also give a non-medical person 140-character access to an expert and a view into the operating room.

4. How was the patient selected? What concerns did he have?

The case/procedure/patient were selected first because of the educational value it would provide to conference participants. The Twittering of the surgery came later.

5. What legal concerns were there? What regulatory issues did you have to consider?

We had received clearance to broadcast the surgery already, so there weren't additional concerns. The procedure itself was already being made public, plus there was no patient identification. Honestly, I was in the in same room during the procedure and I couldn't tell you anything about the patient except that he was male.

6. There is a "conventional wisdom" that medical and related organizations should avoid social media. How would you respond them?

I would disagree. Medical and related organizations have some of the same goals as all organizations. Things like recruitment and brand building to name two, aren't industry specific at all.

Where it gets fuzzy is how far do you extend a conversation with a patient, or a potential patient? Because a person's health is so intimate, you don't want to go barging in. At the same time, and I'm speaking as a person here and not a hospital employee, in trying and frightening times I'd want to feel like I had any sort of additional connection to my doctor or hospital that I could. A tool like Twitter can provide another touch point. The trick is to find the right balance and give patients a way to connect with the organization without being intrusive. I'm not sure where that balance point is or the best way to achieve it.

And then there are the other issues related to privacy, legal, billing and others. But I think that these areas can be handled with policies and procedures.

7. What device was used to tweet in surgery? How was it kept sterile?

We used a laptop with Tweetdeck installed on it. It was outside the sterile field. With it being a robotic surgery, Dr. Khurshid A. Guru, the primary surgeon, was at the controls of the robot instead of standing over the patient. Also, the area for the surgery is being displayed in 3-D on large monitors so those assisting (robotic surgery involves a large team) can see what is happening. This made it possible for the surgeons twittering to have a good view and be able to accurately describe what was happening, and do it from a safe distance.

That's a pretty broad question. As it relates to medical training, I think we need to study a little more to see how formal it can become. Can you offer study credits for following a procedure on Twitter, and what would that entail? Where are the limits to what can effectively be taught with this sort of method? And can Twitter or other social media offer things that current methods can't?

I do think there is considerable opportunity when it comes to research. Not only for collaboration amongst researchers, but even in finding patients for clinical trials.

Finally, from a traditional marketing and PR perspective, budgets for provider marketing are generally pretty limited. Social media does provide a relatively low cost option for spreading your message and reaching out to patients and doctors.